501(r)(4). Four numbers and a letter that can change everything for families facing a medical emergency.
“Basically this is the best kept secret of the Affordable Care Act,” says Jared Walker, founder of Dollar For. Jared’s nonprofit organization advocates for people in medical crisis, helping them avoid the financial crisis that can too easily follow once massive hospital bills start arriving in the mail.
This relatively obscure section of federal law guarantees free or greatly reduced medical care to low income families. But hardly anyone knows about it or how to successfully navigate the complex process hospitals have created to get this financial assistance. The prize at the end of the tunnel is well worth it: bills representing thousands of dollars of medical services simply waived out of existence.
How is this possible? It’s all in knowing the law.
What is Charity Care?
Most people don’t know this, but the majority of hospitals are nonprofits. In order to keep their tax-exempt status, they must prove to the IRS that they are providing community benefit. One of the ways they do this is by offering financial assistance to patients in need–a program widely known as charity care.
“If you are in a certain income range, the hospitals will waive your medical bills. They have to,” Jared says. “People don’t know this, so millions and millions of people are declaring bankruptcy or are on payment plans for medical bills that they do not have to pay.”
It is no secret why hospitals would make their charity care program difficult to find. They’re not going to advertise free medical care. Most hospitals do their bare minimum to maintain their nonprofit status, burying the details of financial assistance deep on their websites or hidden behind layers of confusing information. When people call the number on the bill to inquire, hospital staff are more likely to guide them towards payment plans rather than mention the bill can simply be waived.
But federal guidelines exist for those who know about charity care and speak up for their rights to it.
Getting a Hospital Bill Waived
Dollar For has provided over $20 million in medical debt relief, working with patients in every state to eliminate their medical bills. They’ve collected data from every hospital in the country to create an eligibility screening on their site so patients can see in about 3 minutes whether they are eligible for debt forgiveness.
“This is the lowest hanging fruit to help patients right now,” Jared says. “But it works! We do it every day.”
As a nonprofit organization, Dollar For serves patients absolutely free. Their team fills out the paperwork and faxes it into the hospitals (often the only antiquated way hospitals accept applications). They also do the follow up, overcome roadblocks, and advocate on the patient’s behalf every step of the way.
Dollar For also provides training on their website for patients who might, for privacy reasons, prefer to handle the process themselves. Their self-advocacy track educates patients on their rights and helps them navigate the confusing process to get financial assistance. Patient advocates can be contacted for help at any time by phone or text message.
Without Dollar For, the process is not straightforward. While all hospitals are required to comply with the Affordable Care Act, each has its own guidelines and requirements. States may also have different ways of enacting charity care, which further complicates the patient journey. But the Dollar For team is trained to help and they have a track record of success.
Charity Care for Moms
Dollar For went to the mat for moms when a hospital in Maryland informed their patients that maternity care would not be covered, calling it “an elective service”. Eventually, the hospital backed down when Dollar For proved their actions were not legal.
“We’ve gotten millions of dollars of maternity services covered,” Jared says.
This is great news, especially for moms in the ĒMA program. The majority of families ĒMA serves live at or well below the poverty line. Having kids and caring for them can stretch an already difficult financial situation to its very limits.
“We know that 1 in 3 Americans will just neglect care for fear of the bills,” Jared notes.
This is especially true for low income, single moms who are particularly vulnerable. Financial fear can prevent them from seeking needed care for themselves and their children. But it is the relatively simple preventative care procedures that are critical to heading off a medical crisis.
Shame can also be a powerful factor that stands between people and the help they need. After all, no one wants to be a charity case. But Dollar For ensures no one feels like that from the minute they visit the website all the way through the journey with a patient advocate to get their medical debt waived.
“There is absolutely no reason to be ashamed,” Jared emphasizes. “This is an unavoidable debt. So many Americans deal with this.”
What You Can Do
If this all sounds too good to be true, you’re not alone. But fortunately it is true! People just don’t know about it–especially the people who most need this financial assistance. So what can you do?
SPREAD THE WORD. Hospitals certainly don’t advertise their charity care program or make it easy to find since it is not in their financial interests. You can help make your community aware that financial assistance is available and is a patient’s legal right. Tell someone you know or share about Dollar For on your social media.
COME ALONGSIDE. If you know a family who is struggling financially, come alongside to ensure they know about charity care. You can use the Dollar For website to help them check their eligibility. Don’t wait until a medical crisis hits. Encourage them to apply so they can take care of routine doctor’s visits and preventative procedures for their entire family–free of charge.
REACH OUT.If you are in financial need or journeying with someone who is, the Dollar For team is here to help. Reach out to a patient advocate to get the process started. Even if your hospital tries to deny you, talk to the team to see if something can be done about that bill. They are in your corner!
A conversation with Dr. Baugh on her work at the Urban League and her expertise on the housing crisis and how to help vulnerable families navigate the system.
Dear friends, At Every Mother’s Advocate, we are committed to preventing family separation by advocating for mothers in crisis. We believe in a world where mothers and children are no longer separated for reasons that could be prevented, but equipped and empowered to raise their children in stable and nurturing homes – and we are...
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